Philadelphia, PA– In an unexpected press release, the National Board of Medical Examiners (NBME) revealed that a new Step examination for the United States Medical Licensing Examination (USMLE) was being instituted. The new exam, dubbed USMLE Step Up 4: Take it to the Streets, will be given to interns shortly after Step 3 as a way to promote skills necessary to promote the type of healthcare lacking in the United States currently.

NBMEStep Up 4 will focus on practical practice knowledge such as what street drugs are hot, how to care for homeless patients seeking “2 hots and a cot”, and the appropriate management of uncontrolled social determinants of health.


“We wanted our new exam to be trendy and fitting to the moment in this country. There are complaints that the Step tests do not adequately prepare students to transition to full blown residents, so we thought let’s create a test that addresses the REAL problems in healthcare. Plus, who doesn’t love another board exam?” reports an unidentified board member who approved the new exam.

“The exam will only be offered in Las Vegas and will cost around $10,000 to take. What we plan to do is have a written component which will last 10 hours, and then for the next three days the intern will be whipped by social workers, live in a shantytown, and spend 24 hours in the ED exclusively caring for people who must use the ED for medical care since they lost their insurance. Really, I cannot think of a better way to prepare these doctors to care for this at-risk population.”

Rising intern Jackson Hawks, a young doctor who will be one of the first to take this new exam, shrugged his shoulders when asked about Step Up 4. “What are we going to do? I mean, I’ve wanted to be a doctor for so long, and obviously the social problems in this country solely belong to the medical system, so what’s another board exam?”

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